How does an implant bridge work?
Implants are placed in the jawbone only at the two ends, and the middle is connected with an artificial tooth (pontic) that rests on top of the gums. It's easiest to think of it as building a bridge. With pillars on both sides and the middle connected, chewing force is shared between the two sides.
We often get the question, "Three spaces are empty—do I need all three implanted?" Rather than the number of missing spaces, which spaces have bone that can support a screw decides the structure. Front teeth are narrow and take less chewing force, so connected restorations often do fine over time.
What decides how many implants to place?
| Structure | Force distribution | When it's considered |
|---|---|---|
| One per space | Each implant takes force separately | When bone is sufficient, or with grinding or weak bone quality |
| Implant–pontic–implant | Shared between both sides | When the bone at both ends is strong |
| Implant–implant–pontic | Concentrated on one connection | Only when the end space truly can't be implanted |
If the bone is narrow or the spaces are tight, it's hard to place screws side by side, so placing them at both sides and connecting the middle is sometimes better. In the upper molar area the maxillary sinus sits right above, and in the lower molar area a nerve runs close by, so a space with insufficient bone is sometimes left as a pontic. Methods for adding bone and then placing implants are summarized in the articles bone grafts for implants and sinus lifts.
Is a structure that hangs off only one end OK?
It's not my first choice. A structure where the pontic hangs off only one end is called a cantilever, and every time you chew, force concentrates on the nearby connection like a lever, so the crown can crack or the screw can loosen easily. I consider it, in limited cases, only when the end space truly can't be implanted because of the sinus, a nerve, or lack of bone.
When shouldn't the number be reduced?
- Grinding or clenching: the connected spaces get overloaded
- Insufficient bone or very weak bone quality: it's better to place one each to share the force
- Active periodontitis or difficulty with hygiene: the area under the pontic swells again
Reducing the number in a mouth like this increases the risk of screws loosening or inflammation. Problems like loss of initial stability or a loosened screw can start in one space and spread to all the connected spaces. Reducing surgery and cost is not the answer for every mouth.
Can an implant bridge last a long time?
Fewer implants don't necessarily mean a shorter lifespan. Long-term results depend more on the pontic's position, the bite design, and care than on the number. Implant bodies rarely break, and crowns chipping is mainly a matter of the bite and chewing force. For it to last, you need to be able to clean under the pontic with an interdental brush or a water flosser.
How we do it at Wonjin Dental
We start by looking at which spaces have bone that can hold up, using panoramic and three-dimensional (CT) imaging. We put screws in the spaces that can hold up, and connect the spaces that can't with a pontic in the middle. The opposing teeth, the overall bite, and a shape that can be cleaned are all part of the plan. We don't reduce the number by looking at cost alone.
Wonjin Dental uses Osstem implants (SA ₩300,000, BA ₩500,000, SOI ₩800,000), and an additional restoration such as a pontic is ₩400,000 (as of September 2026). Other items are on the full fee list.
Frequently asked questions
How long does implant bridge treatment take?
Placing implants without a bone graft takes a few months, and it takes longer when a bone graft or sinus lift is added. It depends on when the tooth was extracted, the initial stability, and how fast the implants bond to the bone.
What's the difference between an implant bridge and a regular bridge?
A regular bridge prepares the natural teeth on both sides of the missing space and uses them as pillars. An implant bridge uses implants as pillars, so the healthy neighboring teeth aren't prepared.
Doesn't food get stuck under the pontic?
It can. We make the surface where the pontic touches the gums easy to clean, and show you how to use an interdental brush or water flosser.
If one side of an implant bridge has a problem, does the whole thing have to be redone?
Because it's a connected structure, if one side has a problem, sometimes the whole restoration has to be removed to check it. We also consider that the scope of repair can be larger than with individual implants when deciding the number.
